PrepU: Culture and Diversity

Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for:

client's height

A nurse engages in professional rituals as a means to standardize practice and ensure efficiency. In doing so, the nurse integrates understanding of:

common and observable expressions of culture.

The nurse is caring for a client whose language skills are very limited in the dominant language, and an interpreter has been obtained. The interpreter appears to be telling the client more than the nurse is saying and possibly providing an opinion or medical advice. Which action is appropriate for the nurse to take?

Speak privately with the interpreter and instruct them to only provide language interpretation.

Upon moving to another country, a college student is very confused by many local customs. He is especially bothered by the custom of men and women eating in separate areas and it makes him angry and resentful of the new culture. What are the feelings experienced by this student?

culture shock

The spouse of a client asks the nurse whether the spouse may bring in a cream from home to apply to the client's skin. The spouse says, "Whenever anyone gets sick, we always use this cream." The nurse interprets this as:

ritual

Which nursing intervention reflects culturally appropriate care when addressing a client?

"Good morning, Mr. Smith. I am your nurse, John."

A student nurse is not looking forward to clinical rotation on a geriatric unit, stating "How can I get them to move faster? They always seem so slow!" How should the instructor respond?

"Be careful of the negative attitude in your approach. How fast an individual moves will depend on physical ability not necessarily age."

The nurse is collecting the health history of a client and notes the client is apprehensive in answering questions. The client states, "My spiritual healer will be here soon." What is the best response by the nurse?

"We can wait until your spiritual healer arrives and work together to answer these questions."

The staff nurse overhears the charge nurse, who is of Italian heritage, talking to the unlicensed assistive personnel. Which statement made by the charge nurse is an example of ethnocentrism?

"Italians are best at everything."

A nurse is demonstrating ethnocentrism. Which statement would reflect this concept?

"My Russian heritage is superior to all others."

The nurse is educating a client of Chinese descent regarding the reduction and elimination of lactose in the diet. Which statement(s) made by the client indicates that the education was effective? Select all that apply.

"When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream." "I should replace 2% milk with lactose-free milk." "I can use kosher parve foods because they are prepared without milk."

The nurse is caring for a client who practices Catholicism and was newly diagnosed with cancer. The client states, "God is punishing me for my past sins." How should the nurse respond?

"You sound upset. Would like you to talk about it?"

When providing culturally competent care to clients, a nurse understands that cultural competence involves which characteristics? Select all that apply.

A process that requires life-long learning A commitment to promoting health equity Knowledge of influences on the clients' beliefs Awareness of one's own influences on responses

The nurse is caring for a terminally ill client who immigrated from Mexico. Which nursing intervention regarding spiritual care is appropriate?

Ask the client if a spiritual leader is desired.

The nurse admits a client to the critical care unit to rule out a myocardial infarction. The client has several family members in the waiting room. Which nursing action is most appropriate?

Assess the client's beliefs about family support during hospitalization.

A client is operated on for gallstones. On the postoperative night, the nurse finds that the client is not sleeping and is tossing and turning. When asked about analgesics, the client denies having pain. Which nursing action is most appropriate?

Assessing for nonverbal expressions of pain

The home health nurse is conducting the health history interview with a client who does not speak the dominant language. What would be the best action made by the nurse?

Conduct the health history utilizing a telephonic interpreter (over-the-phone translation).

A nurse is providing care to a medically compromised client with limited ability to speak the dominant language. To obtain information about the client's culture, who would be appropriate for the nurse to use as a key informant? Select all that apply.

Family Friends Interpreters Client's religious contact

A nurse recently hired at a community care clinic is working with a group of culturally diverse clients. How would the nurse supervisor teach and encourage the new nurse on providing culturally competent care?

It is important to include a cultural assessment when evaluating diverse clients so their cultural beliefs and practices can be included in the care plan.

A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply.

Less power Health disparities

Which aspects of nursing make it recognizable as a subculture? Select all that apply.

Manner of dress Language used Rituals

A nurse is conducting a seminar for a group of nurses about the cultural competency in nursing. When describing culture, which terms would be appropriate for the nurse to use? Select all that apply.

Pervasive Holistic Recognizable Ritualistic

The nurse is caring for several clients of different cultures. Which client situation would the nurse recognize as the client with highest risk of culture shock?

The client from Ethiopia states, "All these machines attached to me scare me and I need to get them off."

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle?

The client may have a very different understanding of health promotion.

An older adult client from a minority culture refuses to eat at the nursing home, stating, "I just do not like the food here." What factor should the staff assess for this problem?

The food served may not be culturally appropriate.

The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client?

The interpreter should understand the health care system.

Which is a cultural norm of the health care system?

There is the use of a systematic approach and problem-solving methodology.

The nurse is caring for a client who is terminally ill and recently immigrated to the country. The nurse understands that in order to provide quality end-of-life care for the client, what would be the priority action by the nurse?

Understand the client's personal and cultural views regarding death and dying.

The client, visiting from a foreign country, arrived at the facility seeking medical assistance following an accident. The client has limited proficiency in the dominant language. An onsite certified interpreter is unavailable. To assist in interpretation, what is an appropriate nursing intervention?

Use a contracted video interpretation service.

A nurse is assigned to care for a client who does not speak the dominant language. An interpreter has been contacted and will be at the bedside shortly. Which action by the nurse would be most effective in reassuring the client until the interpreter arrives?

Using reassuring body language and making eye contact to assess needs

A community health nurse is providing care to a group of Hispanic people living in an area that is predominantly populated by white people. What are the Hispanic people in this community an example of?

a minority

The charge nurse overhears two new graduate nurses talking in the break-room. One graduate nurse states, "I hate getting reports from the older nurses; they are just too slow." The charge nurse understands that the nurse is demonstrating what?

ageism

The nurse works in an urban hospital and cares for a diverse population of clients. Which action(s) by the nurse demonstrates the delivery of culturally sensitive care to clients? Select all that apply.

asking the client questions regarding health care beliefs related to the client's culture allowing the client to keep a religious necklace on until going into the operating room integrating the client's cultural practices when assisting with the creation of the plan of care

A client who practices Islam dies at the hospital surrounded by family members. Which action by the nurse demonstrates cultural sensitivity related to the client's death?

consulting the family member prior to performing post-mortem care

The nurse is preparing the discharge plan for a new mother and her newborn son. Which new teaching should the nurse ensure is included after noting the family is Jewish?

care following the scheduled circumcision

A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert?

client

A nurse is providing care for a client who recently immigrated from another country. The nurse says, "You have to get up and walk whether you want to or not." This statement is an example of:

cultural imposition

A nurse is caring for a client with bacterial pneumonia and a temperature of 104°F (40.0°C). Yesterday, the client's temperature was 102°F (38.9°C). The health care provider on call prescribes cool compresses for the client to help lower the fever. The client insists that the nurse bring warm blankets because they will help the client to recover more quickly. The nurse recognizes that the client's request is an example of:

cultural ritual

An immigrant lives with relatives in a community with many households from the country of origin. The client is taken to the emergency department following a fall at work and is admitted to the hospital for observation. The nurse is aware that this client is at risk for:

culture shock

A nurse is caring for an older adult. How does the nurse demonstrate awareness of culturally competent care?

establishing effective communication

Persistent gaps between the health status of minorities and non-minorities are defined as:

health disparities

A nurse is implementing transcultural nursing practice in client care. Which attributes would be important? Select all that apply.

recognizing personal aspects of nurse's own culture understanding the culture of the clients receiving care being aware of the health care system culture

A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms:

require an individualized approach by the nurse.

Which behaviors demonstrated by the client would the nurse consider reflections of the client's pride in ethnicity? Select all that apply.

Requesting native cuisine Listening to folk music and dance Asking to wear unique clothing

The nurse overhears a colleague state, "All people from that client's country are rude." What is the appropriate nursing response?

Respond by saying, "Stereotypes keep us from accepting others as unique individuals."